Passion for Mummy & Baby

There was an air of expectancy as the photographers and I wait for Dr Ann Tan to appear from the dressing room for the cover shoot. The moment she stepped into the room, followed by an entourage of stylists and makeup artist, and the shoot started, it was difficult to imagine she was anyone other than a professional model. She looked great, was easy to work with, and the pictures turned out awesome.

In a little more than an hour, it was a wrap, and Dr Tan turned her full attention to me for this interview. How would your best friend describe you, I asked. She looked a bit bemused at the question, and after some contemplation, replied, “Most people think I am an energizer bunny, always running around, trying to do lots of different things. My mother always said if the candle had 3 ends i would try to burn them all. I really can’t help it, it’s just me trying to do what I think is best for all the people and things I care about.

"People who don't know me so well may think I’m a bit cold or stern but when they get to know me, they are surprised when they realise how friendly I am."

Not only is she friendly, but when one gets to know her, one is also impressed by how caring she is, especially with regards to matters close to her heart – like the welfare of the mummies and babies she takes care of!

“The worst thing I have experienced since becoming a doctor is losing a baby, be it stillbirth or just a miscarriage or when there are severe life threatening problems with mummy. As an obstetrician, I try to reassure mummies that their babies are normal as well as to reassure them that the pregnancy is progressing well. For me to have to tell the mummy that their baby is not healthy or is not going to make it, is really difficult ” even though it may be an early miscarriage or a stillbirth later on in the pregnancy.”

“Whenever the baby goes, I still feel it very personally. I get upset. I can’t really help it, I actually feel a lot. I don’t think I have ever been cold,” sighs this doctor quietly as she reflects on past experiences

“The next most difficult thing in any doctor’s life and for me, is that we have done what we believe to be in the best interest for the patient and for her to believe otherwise,” shares the doctor.

“The best thing to happen, of course, is when the pregnancy is very difficult and it comes out well. Like the baby that premature breakage of the water bag at 21 weeks and we actually managed to keep it in until 28 weeks,” Dr Tan added as a smile lights up her face. “Actually I didn’t believe it could happen but she wanted to try, so I said I’ll work alongside with you, I will try and save the baby with you.

“I told her we would just aim for 28 weeks and smack at 28 weeks, she went into labour and we did the resection, and now, we have a little miracle baby girl running around, and mummy is on to her next pregnancy, which also has its complications,” she laughs.

Being the first Singaporean to hold a Diploma of Fetal Medicine from the Fetal Medicine Foundation (an international body accrediting Fetal Maternal Medicine specialists), Dr Tan is dedicated to the field of prenatal diagnosis and care of both mother and foetus.

The next thing to happen in fetal medicine is the introduction of a new Non Invasive Prenatal Test which uses free fetal DNA from the maternal blood for testing, says Dr Tan. This highly sensitive screening test will help couples determine with a high degree of confidence if their baby has one of the common chromosomal defects eg Trisomy 21, 13 or 18 or abnormalities involving the sex chromosomes. The test can be performed as early as the 10 weeks of pregnancy. Early diagnosis allows patients and doctors more time to decide on the plan for the pregnancy. The current First Trimester Pregnancy Screen is 90 per cent sensitive whilst the NIPT which goes by names of Harmony or MaterniT21 is 98-99 per cent sensitive. Should a positive screen be detected in either case, an invasive diagnostic test needs to be performed so as not to lose a normal child.

Dr Tan explains, “Now you can draw mummy’s blood and have 99 per cent sensitivity of knowing whether she is carrying a defective baby. This is really a breakthrough in the prenatal screening. If the mother is older, or has had several miscarriages and is really hoping to avoid an invasive test, a NIPT could well give her enough reassurance to avoid any invasive testing.

Her hope for the future? Says Dr Tan: “I hope women will be allowed to have more choices over their fertility utilization and preservation. I wish women would consider using their fertility at a younger age and not be overly concerned with the difficulties of raising a family whilst handling a career. However, for those who are not in a position to utilize their fertility but know they wish to be parents, that they be given the opportunity to conserve their eggs and men to conserve their sperms too. I think it’s a rational thing for them to think about saving their fertility. I also wish women would look after their health and nutrition better as that would solve many of the common medical issues in pregnancy and beyond better.”

Dr Ann Tan is the first Singaporean to hold the Diploma of Fetal Medicine from the Fetal Medicine Foundation. She presently serves on the Women’s Health Advisory Committee at the Health Promotion Board. Dr Ann Tan was a Public Service Commission Scholar, and has won several prestigious awards in her field of specialization.

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